Lipase Test: Diagnosing Pancreatic Disorders

What is the Lipase Test?

Lipase is an enzyme produced primarily by the pancreas that breaks down dietary fats in the intestines. The lipase test measures this enzyme in blood. Elevated lipase levels indicate pancreatic damage or disease, making this test crucial for diagnosing pancreatitis and other pancreatic disorders.

Understanding Lipase Levels

Normal Lipase Levels

Normal lipase is less than 60 units per liter (U/L), though normal ranges vary by laboratory. Levels more than three times the upper limit of normal suggest acute pancreatic injury. Mildly elevated levels warrant investigation.

Lipase vs Amylase

Both enzymes are tested for pancreatic disease. Lipase is more specific and sensitive for pancreatitis. Amylase elevates earlier but normalizes faster. Both should be measured together for comprehensive evaluation.

Conditions Causing Elevated Lipase

1. Acute Pancreatitis

Sudden inflammation of the pancreas. Lipase rises 4-8 hours after onset and remains elevated 8-14 days. Severity correlates with lipase elevation. Common causes: gallstones and alcohol.

2. Chronic Pancreatitis

Long-term pancreatic inflammation causing permanent damage. Lipase may be only mildly elevated or normal despite significant dysfunction. Can lead to diabetes and malabsorption.

3. Pancreatic Cancer

May cause mild lipase elevation if duct obstruction or inflammation occurs. Often combined with other findings like elevated bilirubin.

4. Other Conditions

• ✓ Salivary gland disease
• ✓ Intestinal ischemia and bowel perforation
• ✓ Renal failure
• ✓ Certain medications (steroids, diuretics, antiretrovirals)

Symptoms of Pancreatitis

• • Severe upper abdominal pain radiating to back
• • Nausea and vomiting
• • Fever and elevated heart rate
• • Bloating and loss of appetite
• • Greasy, pale stools (chronic pancreatitis)
• • Unintended weight loss

When Should Lipase Testing Be Done?

Immediate lipase testing is needed for acute upper abdominal pain suggesting pancreatitis. Chronic abdominal pain, weight loss, or malabsorption symptoms warrant evaluation. Periodic monitoring helps assess treatment response in known pancreatic disease.

Complementary Tests

• ✓ Amylase (pancreatic inflammation marker)
• ✓ Liver function tests (assess biliary involvement)
• ✓ Calcium levels (may be low in acute pancreatitis)
• ✓ Imaging (ultrasound, CT scan for visualization)